Alter Gas Meter/ Service Position - Request Form
THIS FORM IS AVAILABLE IN LARGE PRINT BY CALLING 13 13 56
Use this form where you (Customer) want to request a quotation from; ATCO Gas Australia Pty Ltd ACN 089 531 975 whose
registered office is situated at 81 Prinsep Road, Jandakot, Perth WA 6164, trading as ATCO Gas Australia (Company), to
relocate a gas meter and/or gas service pipe work upstream of the gas meter. (Do not use this form to request a meter
disconnection or for work on gas pipes/appliances downstream of the gas meter.) This form is not a quotation for any Works.
Fill in all information requested below and sign the form. If Customer is not the owner of the Property (Owner), then each
Owner must also sign the form and guarantee Customer’s obligations (see clause 23 overleaf).
Send completed form to The Company: E-mail: [email protected] or Fax: 1800 219 133 or PO Box 3006, Success WA
6964. Allow at least 2 working days from our receipt for us to contact you on the number you give below.
For all inquiries please ring 13 13 56 between 7:00AM and 6:00PM (Monday – Friday)
The terms printed in this form (including on its reverse) (Terms) apply to your request to the exclusion of all other terms. By
submitting this form you accept and agree to these Terms. Please note that:
•
There will be a measure up and issue of a quotation for the Works (see clause 3 overleaf); and
•
The actual price will be as per the Quotation (see clause 3 overleaf).
Privacy: ATCO Gas Australia collects this information for the purpose of providing our services to you. We may provide the information to
third parties including local government, government authorities and other service providers. For more information on how ATCO Gas Australia
collects, uses, holds and discloses your personal information, see our privacy policy at www.atcogas.com.au/privacy.
Customer
Requesting Alteration
Name: _________________________ ABN: _____________
Tel: _____________________
Address: _________________________________________
Mob: ____________________
_________________________________Post code:________
Email: ___________________
Property Owner
Name: _________________________ ABN: _____________
Tel: _____________________
(if more than one, give details of one
authorised to bind all)
Address: _________________________________________
Mob: ____________________
_________________________________Post code:________
Email: ___________________
Gas Fitter
Name: _________________________ ABN: _____________
Tel: _____________________
(Required if altering Meter Position)
Address: _________________________________________
Mob: ____________________
_________________________________Post code:________
Email: ___________________
Name: _________________________ ABN: _____________
Tel: _____________________
Address: _________________________________________
Mob: ____________________
_________________________________Post code:________
Email: ___________________
(Mandatory Field)
Builder
(if applicable)
Property
where Works required
(Mandatory Field)
Unit: ________ Street no: _______ Lot: _______
Street: _________________________________________________________
Suburb/Town: __________________________________________ Post code:__________
Gas meter (Mandatory Field)
Number: _____________________ (as displayed on gas meter and gas account from retailer)
Works
requested (tick one only)
 Alter position of the existing gas meter on the property
 Alter position of gas service only, not affecting the position of existing gas meter
THIS FORM IS NOT APPLICABLE IF UPSIZING OF MTR IS REQUIRED – CONTACT YOUR GAS RETAILER
Each of Customer and Owner now jointly and individually accepts and agrees to the Terms as a binding contract (this
Agreement) and requests ATCO Gas Australia to attend the Property at a time to be arranged with Customer, to measure up
and do all other things necessary (Measure Up Works) to issue a written quotation for the Works.
Accepted & Agreed:
Signatures
Date
Signed by the Customer:
(Mandatory Field)
Signed by each Owner:
(Mandatory Field)
Document No.:
Revision:
Issue Date:
NCN WI007 RF04
7
8/03/2016
Page 1 of 2
Alter Gas Meter/ Service Position - Request Form
Additional Terms
Measure Up Works
1.
If Customer submits a duly completed Request Form in accordance with the
Terms, The Company will endeavour to contact Customer or its representative
using the contact information supplied in the Request Form to arrange a mutually
convenient time for The Company to attend the Property for the Measure Up
Works. The Company will endeavour to attend the Property at that time.
2.
Customer or its representative will be present at the Property at the pre-arranged
time for The Company to do the Measure Up Works, and Customer will ensure
The Company is allowed free and ready access to the Property (and all relevant
parts of it, including any garage) to do the Measure Up Works and is not otherwise
hindered or prevented from safely performing the Measure Up Works.
Quotations
3.
The Actual Price and other terms for supply of any Works are as set out in the
written quotation issued by The Company for those Works (Quotation) (even if
inconsistent with this document or any other conduct).
The Company is under no obligation to provide any Works unless and until The
Company’ Quotation for those Works has been duly accepted within the applicable
acceptance period. This document is not a quotation.
Downstream work
4.
Customer must engage a licensed gas fitter to perform any work on its gas pipes
or appliances downstream of the gas meter. The Company has no responsibility
to perform any work downstream of the gas meter.
Gas Hazards
5.
If any thing is discovered or arises at any time in relation to the supply of gas at
the Property which The Company considers to be illegal or unsafe, The Company
may (without prejudice to any other right it may have) disconnect or otherwise stop
the supply of gas to the Property until the illegality or lack of safety is rectified.
This may mean that the supply of gas cannot be recommenced until Customer or
Owner has, using a licensed gas fitter, ensured that the gas pipes and appliances
downstream of the gas meter are safe and otherwise compliant with all applicable
legal or regulatory requirements.
Site preparation, work and reinstatement
6.
The Company will endeavour so far as is reasonable and practicable in the
circumstances to take reasonable care when conducting any Measure Up Works
to cause as little detriment or inconvenience and as little damage as is reasonably
possible at the Property. However, in relation to performing some Measure Up
Works, The Company may need to create access openings or otherwise break,
damage or disturb surfaces, coatings, structures, ground, landscaping and other
things (including any paving, concrete, bitumen, building, wall, fence, sign, floor,
ceiling, pipe, conduit, cable, tree or plant) (Surfaces & Structures) whether within
or outside the Property boundary, and it is agreed that in doing so The Company
is taken to be neither negligent nor in breach of contract or any law.
7.
Customer is and remains solely responsible for:
7.1
reinstatement and repair of all Surfaces & Structures within the Property boundary
and (where any Measure Up Works or related acts, matters or things extend
outside the Property) in or on the road reserve or any other property outside the
Property;
7.2
drawing The Company’ attention to and clearly marking the location of all services
(including electricity and telecommunication cables and conduits), reticulation,
safety hazards and other items requiring special protection, controls and care at
the Property;
7.3
controlling or assisting The Company with the safe control of all safety hazards or
other things at the Property requiring special protection or controls (including
keeping all people, animals and ignition sources a safe distance away from The
Company’ work, materials and vehicles); and
7.4
ensuring full and timely compliance with all responsibilities and other liabilities of
an owner or occupier of the Property.
8.
Supplying the Measure Up Works may involve interruption to the supply of gas,
power, water, telecommunication and other services to the Property and/or may
restrict access to or use of the Property. Customer must take precautionary
measures to allow for such interruption and/or restricted access or use (including
by having in place alternative means of supply and/or access) and ensure that no
one (including, tenants, visitors and customers) relies (for example to conduct any
business) solely on the services that may be interrupted or the access or use that
may be restricted.
Agreement terms and Liability Limitations
9.
The terms of this Agreement are the terms expressly set out in this document and
any terms implied by law into this Agreement that cannot lawfully be excluded (for
example, if Customer is a “consumer” (as defined using the principles applied by
the courts), those terms implied by consumer protection laws into this Agreement
that cannot be excluded). No other terms apply.
10.
Subject to clause 15, The Company accepts its liability to Customer and Owner to
the extent caused by The Company’ breach of contract or negligence:
10.1 for any personal injury or death to Customer, Owner or their respective
employees, agents or contractors in relation to supplying the Measure Up Works;
10.2 for any physical damage to Customer’s or Owner’s real or tangible property
resulting directly and flowing naturally from the supply of the Measure Up Works,
but The Company limits its liability to (as The Company chooses) repairing or
replacing the property or paying to do so; and
10.3 for any other cost or expense Customer or Owner reasonably incurs that is a
direct result of, and flows naturally from, such breach or negligence, but The
Document No.:
Revision:
Issue Date:
NCN WI007 RF04
7
8/03/2016
Company limits its liability for all such claims in aggregate to the total amount
payable to The Company under this Agreement.
11.
Despite clause 14, The Company is not liable to Customer, Owner or any other
person in any way or on any basis whatsoever (including for breach of contract,
tort (including negligence) or breach of any other law) for any breach, failure, loss
or damage:
11.1 to the extent that it is caused by Customer, Owner or their respective employees,
agents or contractors (for example, through Customer’s negligence or breach of
contract) or results from any of them failing to take reasonable steps to avoid or
minimise their loss;
11.2 arising from circumstances outside The Company’ reasonable control (for
example, a failure in equipment that The Company does not own or operate,
industrial action or an act of God); or
11.3 to the extent that it is indirect or consequential loss, loss of revenue, loss of profit,
loss of use, loss of opportunity, loss of anticipated savings, loss of goodwill, loss of
data or economic loss.
12.
Except for the liability The Company accepts under clauses 13 and 14, The
Company excludes all other liability to Customer, Owner or any other person in
any way or on any basis whatsoever (including for breach of contract, tort
(including negligence) or breach of any other law).
13.
For any liability which cannot lawfully be excluded as provided in clauses 15 or 16,
The Company’ liability is limited to The Company’ choice of resupplying or paying
the cost of resupplying services and repairing, replacing or paying the cost of
repairing or replacing goods.
14.
In these Terms, any limitation or exclusion of liability in favour of The Company
applies to the maximum extent permitted by law and is in favour of (and may be
relied upon by) all and any of The Company, its related bodies corporate and any
officers, employees, agents, consultants, contractors and representatives of any of
them, jointly and individually.
15.
These provisions relating to liability will continue unaffected by any termination of
this Agreement or cancellation or suspension of the Works.
Agents and Contractors
16.
The Company may exercise any right or perform any obligation (including
performing any Measure up Works) itself or by or through any related body
corporate, or any officer, employee, agent, consultant, contractor or representative
of any of them. However, no contractor is authorised or permitted by The
Company to make or issue any offer, quotation, acceptance or representation on
behalf of The Company to any person (except to issue a Quotation for performing
Works on The Company’ standard form printed Quotation form); or to alter any
prices or other terms issued, quoted or agreed by The Company from time to time.
Consents
17.
Each of Customer and Owner consents to The Company collecting and using any
personal information for purposes relating to Measure up Works or Works
(including sharing it with any third party for such purposes).
18.
Each of Customer and Owner warrants and represents that each owner and each
occupier of the Property has been informed of and consented to the Measure Up
Works and that Customer or Owner has obtained (or will have obtained by the
time it is necessary to have obtained them) all necessary third party consents,
licences and approvals for The Company to do the Measure Up Works and for
releasing any information arising from or in relation to any actual or proposed
Works to Customer, Owner, any other owner or occupier of the Property or any
government agency or regulatory body.
Guarantee & indemnity
19.
Owner unconditionally and irrevocably guarantees to The Company the due and
punctual performance by Customer of its obligations under this Agreement. As a
separate undertaking, Owner indemnifies The Company fully against all liability or
loss arising from or incurred in connection with a breach by Customer or Owner of
this Agreement. Owner’s liability under this clause 23 is not affected by anything
which might release or exonerate or otherwise affect it at law or in equity, including
The Company granting time or other indulgence to, compromising with or partially
releasing Customer in any way; any acquiescence, delay, acts or omissions on the
part of The Company; any variation or novation of a right of Customer or The
Company; any alteration of this Agreement or any agreement entered into in the
performance of this Agreement, with or without the consent of Owner; or the
invalidity or unenforceability of an obligation or liability of a person other than
Owner.
General
20.
In these Terms, the words “for example”, “include”, “includes”, “including” and “for
example” are not used as words of limitation, clause headings are not Terms and
any choice, consent or determination by The Company is in its absolute discretion.
21.
No provision of this Agreement may be varied other than in writing executed by
The Company and Customer.
22.
The rights and remedies of The Company and duties and obligations of any or
both of Customer and Owner in this Agreement are in addition to other rights and
remedies given to The Company and duties and obligations imposed on any or
both of Customer and Owner, by law or any regulatory body.
23.
In the interpretation of any provision forming part of these Terms or this
Agreement, no rule of contract interpretation applies to the disadvantage of a party
on the basis that it drafted or put forward that provision or any part of it. Any
provision that is unlawful may be severed from this Agreement.
24.
These Terms and this Agreement are governed by the laws applicable in Western
Australia, Australia.
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